\r\n\tNotably, the book encourages academic scholars and researchers to contribute to the modern concepts of CSR. Fundamentally, it speaks for well-developed literature for entrepreneurs and managers, thus assisting them in the decision-making process. \r\n\tFurthermore, this book is of great value to policymakers, practitioners, and corporations, thus contributing to various disciplines (e.g., social science and management). \r\n\tThese proposed themes encourage future researchers and professionals to share their ideas, concepts and work concerning these subject domains. All these suggested topics had recommended under the rubrics of CSR. Perhaps, all the professionals, researchers, and scholars are welcome to submit their piece of work, in particular to the suggested topics. \r\n\tIndeed, the recommended topics include the following but are not limited to these only. \r\n\t• Corporate Governance and Sustainability \r\n\t• Green Innovation and CSR \r\n\t• Social Entrepreneurship \r\n\t• Green Economy and Social and Environmental Sustainability \r\n\t• Sustainable Development and Industrialization
",isbn:"978-1-80356-165-3",printIsbn:"978-1-80356-164-6",pdfIsbn:"978-1-80356-166-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"e3be182f32c4d9b8e44e95e86ee1366b",bookSignature:"Dr. Muddassar Sarfraz",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11602.jpg",keywords:"Sustainability, Stakeholders, Corporate Citizenship, Sustainable Development, Decision-making Process, CSR, Organizational Performance, Financial Performance, Corporate Reputation, Environmental Performance, Environmental Strategy, Green Innovation",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 2nd 2022",dateEndSecondStepPublish:"March 2nd 2022",dateEndThirdStepPublish:"May 1st 2022",dateEndFourthStepPublish:"July 20th 2022",dateEndFifthStepPublish:"September 18th 2022",remainingDaysToSecondStep:"3 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"A pioneering researcher in Business Management and Sustainability, Associate Editor of Frontiers in Psychology Journal, and published several research articles.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"260655",title:"Dr.",name:"Muddassar",middleName:null,surname:"Sarfraz",slug:"muddassar-sarfraz",fullName:"Muddassar Sarfraz",profilePictureURL:"https://mts.intechopen.com/storage/users/260655/images/system/260655.jpeg",biography:"Dr. Muddassar Sarfraz works as an assistant professor at Wuxi University, China. 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1. Introduction
The medical, rehabilitation and bio-mimetic technologydemands human actuated devices which can support in the daily life activities such as functional assistance or functional substitution of human organs. These devices can be used in the form of prosthetic, skeletal and artificial muscles devices (Andreasen et al., 2005; Bitzer & Smagt, 2006; DoNascimento et al., 2008). However, we still have some difficulties in the practical use of these devices. The major challenges to overcome are the acquisition of the user’s intention from his or her bionic signals and to provide with an appropriate control signal for the device. Also, we need to consider the mechanical design issues such as lightweight and small size with flexible behavior etc (Arieta et al., 2006;Shenoy et al., 2008). For the bionic signals, the electromyography (EMG) signal can be used to control these devices, which reflect the muscles motion, and can be acquired from the body surface. We are familiar with the fact that ionic polymer metal composite (IPMC) has tremendous potential as an artificial muscle. This can be stimulated by supplying a small voltage of 3V and shows evidence of a large bending behavior (Shahinpoor & Kim, 2001; 2002; 2004; Bar-Cohen, 2002).In place of the supply voltage from external source for actuating an IPMC, EMG signal can be used where EMG electrodes show a reliable approach to extract voltage signal from body (Jain et al. 2010a;2010b; 2011). Using this voltage signal via EMG sensor, IPMC can illustrate the bio-mimetic behavior through the movement of human muscles. Therefore, an IPMC is used as an artificial muscle finger for the bio-mimetic/micro robot.
The main objective of this chapter is to discuss the design and control of an IPMC based artificial muscle finger where this finger is actuated by EMG signal via movement of human finger. The movement is sensed by EMG sensor which provides signal for actuating the IPMC. When designing IPMC artificial muscle finger based micro gripper for handling the light weight components in an assembly, IPMC bending behaviour is utilized to hold the object. During holding the object, stable EMG signal is required. For this purpose, stable EMG signal is sent through proportional–integral–derivative (PID) controller to the system. Experimentally, it is found that IPMC based artificial muscle finger achieves similar movement like human index finger. This IPMC based artificial muscle finger attains deflection upto 12 mm. By developing a prototype of IPMC artificial muscle finger based micro gripper, it is demonstrated that EMG driven system like IPMC artificial muscle finger based micro gripper can be applicable in handling of light weight components. The major advantages of such system are that IPMC based artificial muscle finger tip shows the compliant behavior and consumes less energy for actuation. Therefore, EMG driven system shows enough potential to substitute for conventional mechanism in micro manipulation and rehabilitation technology.
This chapter is organized as follows: Section 2 describes the prior research related to EMG applications in robotics and bio-mimetics. Section 3.1 explains the basic design of IPMC artificial muscle finger based micro gripper which is driven by EMG signal. The basic tendon of index finger is studied in section 3.2 where muscles are identified for actuation of IPMC based artificial muscle finger. In section 3.3, a model for controlling the EMG signal is highlighted. Different types of control system are implemented for achieving stable data from EMG signal via index finger which is sent to IPMCbased artificial muscle finger. Section 4 discusses experimental testing setup for activation of IPMC based artificial muscle finger by human finger through EMG. In section 5, the results are discussed and the conclusions are drawn in section 6.The future work is recommended in section 7.
2. Prior research related to EMG applications
In the past, some researchers have reported work related to shape memory alloy (SMA) and other similar actuators to develop the bio-mimetic fingers but IPMC artificial muscle based finger related work is limited. Pfeiffer et al. (1999) have designed artificial limbs and robot prostheses that are lightweight, compact and dexterous. This mimics the human anatomy and maintains a high lifting capability. EMG control is used for SMA actuated fingers in robot prostheses. De Laurentis & Mavroidis (2002) have discussed the design of a 12 degree-of-freedom (DOF) SMA actuated artificial hand where the SMA wires are embedded intrinsically within the hand structure. Cocaud & Jnifene (2003) have investigated the use of artificial muscles as SMA actuators for robot manipulators. A solution is established in order to determine the optimal position of a muscle in various musculoskeletal configurations. Herrera et al. (2004) have also designed and constructed a prosthesis where linear actuators are used for designing the mechanical system and EMG sensors are introduced for designing the electrical control system. Bundhoo et al. (2005, 2008) have reported the design of artificially actuated finger by SMA towards development of bio-mimetic prosthetic hands. Different finger joints are actuated through SMA wires via EMG and the relationship between elongation/contraction of the SMA wires & the finger joints have been obtained. O’Toole & McGrath (2007) have also focused on mechanical design of a 12 DOF SMA actuated artificial hand. The SMA material is used for combination of high strength polymers such as polytetrafluoroethylene (PTFE), polyether ether ketone (PEEK) and low density metals such as titanium.Lau (2009) have carried out research work on a design and development of an intelligent prosthetic hand based on hybrid actuation through DC motor & SMA wires. These are controlled by myoelectric signal. Two novel features are introduced in the new prosthetic hand. Firstly, its hybrid actuation mechanism has the advantage of increasing the active degrees of freedom and secondly, using only two myoelectric sensors, has the potential for controlling more than three patterns of fingers movements. Pittaccio & Viscuso (2011) have developed a SMA wire device for the rehabilitation of the ankle joint where active orthosis powered by two rotary actuators like, NiTi wire are used to obtain ankle dorsiflexion and EMG signal is used to control the orthosis and trigger activation from muscle. Stirling et al. (2011) have shown the potential of SMA wire for an active, soft orthotic in the knee where NiTi based SMA wires is also used. A prototype is tested on a suspended, robotic leg to simulate the swing phase of a typical gait. Thayer & Priya (2011) have designed a biomimetic dexterous humanoid hand where the dexterity of the DART hand have been measured by quantifying functionality and typing speed on a standard keyboard. The hand consists of 16 servo motors dedicated to finger motion and three motors for wrist motion where some of joints are activated through SMA wires.
Some of the researchers have focused on the design of a biomechatronic robotic hand using EMG. Cheron et al. (1996) have found the relationship between EMGand the arm kinematics through dynamic recurrent neural networks (DRNN) method whereasHudgins et al. (1997) have focused on a new control scheme, based on the recognition of naturally myoelectric signal patterns, transfers the burden of multifunction myoelectric control from the amputee to the control system. Rosen et al. (2001) have developed a myosignal-based exoskeleton system. This is implemented in an elbow joint, naturally controlled by the human. The human–machine interface is set at the neuromuscular level, by using the neuromuscular signal (EMG) as the primary command signal for the exoskeleton system. The EMG signals along with the joint kinematics are fed into a myoprocessor (Hill-based muscle model) which in turn predicts the muscle moments on the elbow joint. Banks (2001) has given remarkable effort towards design and control of an anthropomorphic robotic finger with multi-point tactile sensation whereas Light et al. (2002) have emphasized on intelligent multifunction myoelectric control of hand prostheses. Peleg et al. (2002) have extracted multiple features via EMG signal from hand amputees which is selected by help of a genetic algorithm. Fukuda et al. (2003) have developed a prosthetic hand where human-assisting manipulator system based on the EMG signals is utilized. Wheeler (2003) has presented a neuro-electric interface method for virtual device control. The sampled EMG data is taken from forearm and then is fed into pattern recognition software that has been trained to distinguish gestures from a given gesture set. Krysztoforski et al. (2004) have given remarkable effort towards recognition of palm finger movements on the basis of EMG signals with the application of wavelets.
Crawford et al. (2005) have used EMG signals for classifying in real-time with an extremely high degree of accuracy in a robotic arm-and-gripper. A linear support vector machines (SVM) based classifier and a sparse feature representation of the EMG signal are used. Hidalgoet al. (2005) have proposed a design ofrobotic arm employing fuzzyalgorithms to interpretEMG signals from the flexor carpi radialis, extensor carpi radialis and biceps brachiimuscles. The control and acquisition systems are composedof a microprocessor, analog filtering, digital filtering & frequency analysis, and finally a fuzzy control system.Mobasser & Hashtrudi-Zaad (2005) have estimated rowing stroke force with EMG signal using artificial neural network method from upper armmuscles which is involved in elbow joint movement,sensed elbowangular position and velocity.Gao et al. (2006) have focused on acquiring the data from the upper limb of the body for robotic arm motion using EMG whereas Frigo et al. (2007) have detected EMG signal from voluntarily activated muscles which is controlled for functional neuromuscular by electrical stimulation. A comb filter (with and without a blanking window) is applied to remove the signal components synchronously correlated to the stimulus. Roy et al. (2007) have compared the performance of different sEMG signal at various conditions. These performances depend on the electro-mechanical stability between the sensor and its contact with skin. Zollo et al. (2007) have put a remarkable effort on the control system of biomechatronic robotic hand and on the optimization of the hand design in order to obtain human like kinematics and dynamics. By evaluating the simulated hand performance, the mechanical design is iteratively refined. The mechanical structure and the ratio between numbers of actuators to the number of DOF have been optimized. Yagiz et al. (2007) have developed a dynamic model of the prosthetic finger where a non chattering robust sliding mode control is applied to make the model follow a certain trajectory. Wege & Zimmermann (2007) have shown the potential of EMG control for a hand exoskeleton device. The device has been developed with focus on support of the rehabilitation process after hand injuries or strokes. Itoh et al. (2007) have studied the hand finger operation using sEMG during crookedness state of the finger. Two electrodes (Ag/AgCl electrodes) are sticked randomly on the forearm muscles and the intensity of EMG signals at different muscles is measured for each crooked finger.
Hao et al. (2008) have studied the design of pneumatic muscle actuator based robotic hand where its compliance and dexterity handling are attempted.A single finger is controlled by fuzzy & PID controller and comparative studies are discussed. Murphy et al. (2008) have explored the micro electro-mechanical systems based sensor for mechanomyography system whereas Saponas et al. (2008) have also explored the feasibility on muscle-computer interaction methodology that directly senses and decodes human muscular activity rather than relying on physical device actuation or user actions. Andrews (2008) has determined an effective approach to finger movement classification in typing tasks using myoelectric data which are collected from the forearm. Cesqui et al. (2008) have explored the use of EMG signals for post-stroke and robot-mediated therapy. In this work, a pilot study has been reported under young and healthy subjects where experiments are conducted to determine whether it is possible to build a static map to cluster EMG activation patterns for horizontal reaching movements. Chen et al. (2008) have implemented an EMG feedback control method with functional electrical stimulation cycling system (FESCS) for stroke patients. The stroke patients often suffer from low limbs paralysis. By designing the feedback control protocol of FESCS, the physiological signal is recorded with help of FPGA biomedical module, DAC and electrical stimulation circuit. Leeet al. (2009) have described a development procedure of bio-mimetic robot hand and its control scheme where each robot hand has four under-actuated fingers, which are driven by two linear actuators coupled together. Dalley et al. (2009) have given emphasis of an anthropomorphic hand prosthesis that is intended for use with a multiple-channel myoelectric interface. The hand contains 16 joints, which are differentially driven by a set of five independent actuators. Hu et al. (2009) have presented a comparison between electromyography-driven robot and passive motion device on wrist rehabilitation for chronic stroke patients. By comparative study, it was found that the EMG-driven interactive training had a better long-term effect than the continuous passive movement (CPM) treatment.
Blouin et al. (2010) have focused on control of arm movement during body motion as revealed by EMG whereas Luo &Chang (2010) have explored a feasibility study on EMGsignal integrated with multi-finger robot hand control for massage therapy applications. The forearm EMG of a person massaged by the human hands is recorded and analyzedstatistically. Khokhar et al. (2010) have showed the potential of EMG applications whereSVMclassificationtechnique is suitable for real-time classification of sEMG signals. This technique is effectivelyimplemented for controlling an exoskeleton device.Huang et al. (2010) have designed a robust EMG sensing interfacefor pattern classification. The aim of this study was to design sensor fault detection (SFD) module through the sensor interface to provide reliable EMG pattern classification.This module monitors the recorded signals from individual EMG electrodes and performs a self-recovery strategy to recover the classification performance when one or more sensors are disturbed.Naik et al. (2010) has studied the pattern classification of myo-electric signal during different maximum voluntary contractions using BSS techniques for a blind person whereas Artemiadis & Kyriakopoulos (2010 & 2011) have presented a switching regime model for the EMG-based control of a robot arm where decode the EMG activity of 11 muscles has a continuous representationof arm motion in the 3-Dspace.The switching regime model isused to overcome the main difficulties of the EMG-based controlsystems, i.e. the nonlinearity of the relationship between the EMGrecordings and the arm motion, as well as the non-stationary ofEMG signals with respect to time.Vogel et al. (2011) have demonstrated the robotic arm/hand system that is controlled in real time in 6 dimension Cartesian space through measured human muscular activity via EMG. DLR Light-weight Robot III is used during demonstration of impedance control. Li et al. (2011) have presented a robot control system using four different gestures from an arm. These are achieved by EMG signal using phase synchrony features.The phase synchrony analysis using the recent multivariateextensions of empirical mode decomposition(MEMD) is carried out. Joshi et al. (2011) have focused on brain-muscle-computer interface using a single sEMG signal. Initial results show that the human neuromuscular system can simultaneously manipulatepartial power in two separate frequency bands of a sEMG powerspectrum at a single muscle site.Matsubara et al. (2011) have proposed an interface to intuitively control robotic devices using myoelectric signals. Through learning procedure, a set of myoelectric signals is captured from multiple subjects in the system and it can be used as an adaptation procedure to a new user after only a few interactions.
Recently, Ahmad et al. (2012) have presented a review report on different techniques of EMG data recording where condition of an ideal pre-amplifier, signal conditioning and its amplification are discussed. Sun et al. (2012) have conducted an isokinetic exercise to realize the characteristics of femoral muscles in human knee movement through EMG where a mechanical model of muscle for human knee movement is established.Qi et al. (2012) have developed algorithms for muscle-fatigue detection and muscle-recruitment patterns in routine wheelchair propulsion scenarios, e.g., daily practice where for analysis purpose two speeds of muscular behavior are chosen. Gandole (2012) has developed an artificial intelligent model using focused time lagged recurrent neural network (FTLRNN) method with a single hidden layer. FTLRNN method reduces noise intelligently from the EMG signal. Chan et al. (2012) have developed an assessment platform for upper limb myoelectric prosthetic devices using EMG. The assessment platform consists of an acquisition module, a signal capture module, a programmable signal generation moduleand an activation & measurement module. The platform is designed to create a sequence of activation signals from EMG data captured from a patient.
An EAP actuator based design for IPMC fingers have been discussed by Biddiss&Chau (2006). This shows the potential of electroactive polymeric sensors within an operating range of voltage (3V) whereas Kottke et al. (2007) have reported on how to stimulate and activate a non-biological muscle such as an IPMC. Lee et al. (2006, 2007) have also demonstrated the potential of an IPMC actuating system with a bio-mimetic function using EMG signals. A mean absolute method is used for achieving the filtered EMG signal. Aravinthan et al. (2010) have designed a multiple axis prosthetic hand using IPMC. EMG signal through programmable interface controller (PIC) is sent to the IPMC prosthetic material to perform the required actions. By doing experiments, the potential of prosthetic hand using IPMC is shown.After that, we have also demonstrated actuation of IPMC through EMG via forearm muscles where potential of IPMC based micro robotic arm has been shown for lifting the object (Jain et al., 2010a; 2010b; 2011; 2012). For further application of EMG driven system, we are discussing detailed analysis of EMG signal control point view of IPMC based artificial muscle finger for micro gripper in this chapter.
3. Design and control of IPMC based artificial finger driven by EMG signal
3.1. Basic design of IPMC artificial muscle finger based micro gripper using EMG
For designing an IPMC artificial muscle finger based micro gripper using EMG, an IPMC strip (Size 40 mm 10 mm 0.2 mm) that imitates human finger movement, is assumed to be artificial muscle finger. This is fixed with holder and another plastic based finger of similar size is made for supporting the micro object as shown in Fig. 1. When human index finger moves up and down, it creates potential difference by its movements. This potential difference is transferred through EMG electrodes into the artificial muscle finger so that this finger is able to move accordingly and holdthe object. The main function of EMG electrode is to detect the voltage from human muscles since human muscles generate few milli-voltages when they are contracting or expanding during movement. For transferring this voltage signal to actuate the artificial muscle finger, it needs the amplification setup which is discussed in section 4. Therefore, IPMC based artificial muscle finger is activated using EMG and it allows holding an object for micro assembly operation.
Figure 1.
Schematic diagram of IPMC artificial muscle finger based micro gripper driven by EMG
Figure 2.
Schematic diagram of the actuation mechanism of IPMC (Chen et al., 2011)
During development of an EMG driven IPMCbased artificial muscle finger, a typical IPMC strip (Procured custom made from Environmental Robots Inc., USA) is used which has a thin (approximately 200 μm) perfluorinated ion exchange base polymer membrane (Nafion-117) with metal electrodes of platinum (5–10 μm) fused on either side. As a part of the manufacturing process, this base polymer is further chemically coated with metal ions that comprise the metallic composites. It responds in wet/dry condition. An IPMC is usually kept in a hydrated state to ensure proper dynamic operation. When the material is hydrated, the cations will diffuse toward an electrode on the material surface under an applied electric field. Inside the polymer structure, anions are interconnected as clusters providing channels for the cations to flow towards the electrode (Chen et al., 2011). This motion of ions causes the structure to bend toward the anode as shown in Fig. 2. An applied electric field affects the cation distribution within the membrane, forcing the cations to migrate towards the cathode. This change in the cation distribution produces two thin layers, one near the anode and another near the cathode boundaries. The potential is generated by changing the potential electric field on cluster of ionic strips that provides the actuation of the strip.
3.2. Basic tendon of index finger for identification of EMG signal
To examine the bio-mimetic behavior of IPMC based artificial muscle finger, it is important to study the physiological structure of human finger. An internal structure of human index finger is shown in Fig. 3. The index finger is actuated by three intrinsic muscles and four extrinsic muscles. The intrinsic muscles consist of two interosseous (IO 1 and IO 2) muscles & one lumbrical (LU) muscle and four extrinsic muscles connected through long tendons i.e. extensor digitorum communis (EDC), extensor indicis proprius (EIP), flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) (Bundhoo & Park, 2005). For heavy lifting & holding purpose, EDC and EIP are responsible in tendon network. Consequently, EMG electrodes are placed at these two positions on the human finger so that we can achieve direct actuation of IPMC based artificial muscle fingerthrough said muscles.
Figure 3.
Basic tendons of the index finger (Bundhoo& Park, 2005)
3.3. Model for controlling the EMG signal for IPMC based artificial muscle finger
For acquiring the data from said muscles, EMG electrodes are placed for measuring the electric potential produced by voluntary contraction of muscle fiber on the human finger. The frequency range of the EMG signal is within 4 to 900 Hz. The dominant energy is concentrated in the range of 95 Hz and amplitude of voltage range is ±1.2 mV according to muscle contraction and the voltage function Vin(t) in term of signal sample time (t) is given below,
Vin(t)=Vinosin(2πft)E1
Where, Vinois amplitude of EMG voltage (0.0012V); f is frequency of EMG signal (95 Hz).
In Laplace domain, EMG input signal is written as
Vin(s)=2.96s2+3.51e5E2
Using these parameters, the circuit for filtered EMG signal is designed using MATLAB SIMULINK software as shown in Fig. 4.
Figure 4.
Block diagram of EMG signal behaviour from human index finger
In block diagram, the active EMG signal is taken from index finger muscle and uniform noise is considered. The electric potential is first amplified with gain 32 dB and then band pass filter (BPF) is used within specified frequency range (4 to 900 Hz). Using two band stop filters (BSF and BSF1), noise signal (60 Hz) that arises due to AC coupled power is eliminated. The signal is then passed through an amplifier with gain 60 dB. Subsequently, three integrators (Integrator, Integrator1 and Integrator2) are used for achieving better damped signal. The output of EMG signal with sampling time of 10-4 seconds after filtering is shown in Fig. 5.
Figure 5.
Acquired data from finger muscles via EMG signal
Thus, the total output duration of EMG signal for sampled data is 0.1 second. The general solution of acquired EMG voltage (VEMG) through curve fitting method is obtained as given below,
VEMG(t)=∑V0sin(2πf0t+δ0),
0≤t≤0.1E3
\n\t\t\t\t
where, V0 is the amplitude of EMG voltage of sine function (0.0012 V); f0 is average frequency of sine function (4.7 Hz); 0 is initial phase difference of sine function (1.66 rad); t is signal sample time in second.
After adjustment of root mean square (RMS) value of this sine function, the EMG voltage VEMGrms(s) after filtering is written as
For controlling purpose, single input single output (SISO) control system tool in MATLAB is used and the output VEMG(s) data is obtained. The initial overall transfer function of EMG voltage VEMGinitial (s) is obtained through output signal from (4) to input signal from (2) and is given as
After that, Nyquist criterion is applied to check the stability of EMG signal. The root-locus and bode scheme are plotted as shown in Fig. 6.
Figure 6.
Root-locus and bode plot behaviour of EMG signal via finger in initial condition (Jain et al., 2011)
It is found that the zero-poles have real value on both sides of the real axis which does not meet theNyquist stability criteria. Also from Fig. 6,gain cross-over frequency (GCF=2.53 rad/s) is greater than phase cross-over frequency (PCF=1.18 rad/s), indicating that this voltageobtained from EMG signal is unstable.
For achieving the stable EMG signal, different configurations of PID are analysed through SISO control tool of MATLAB software. By applying PD control with proportional control gain factor (Kp=1) and derivative control gain factor (Kd=1), EMG voltage VEMGfinal 1(s) is obtained as given below,
The root locus and bode plot are shown in Fig. 7. This indicates that the obtained data from EMG signal is unstable but through this control system the data is converging towards stability from initial condition.
Figure 7.
Root-locus and bode plot behaviour of human finger through PD controller
In case of PI controller, the unit proportional control gain factor (Kp=1) and integrator control gain factor (Ki=1) parameters are used. After applying this control system, EMG voltage VEMGfinal 2(s) is obtained as given below,
VEMGfinal2(s)=3.92e-6 s (s2+1.17e-4) (s2+3.51e5)(s+0.724)(s2+ 9.91e-9s + 1.17e-4)(s2-0.724s+1.90)E7
The bode plot and root locus for this system are plotted as shown in Fig. 8.From this figure, it shows that the data from EMG signalis again unstable but the response has a better prospect of converging towards stability than previous configuration.
Figure 8.
Root-locus and bode plot behaviour of EMG signal via finger through PI controller
After that, PID controller is used where proportional control gain factor (Kp= 0.5), integrator control gain factor (Ki= 1) and derivative control gain factor (Kd=1) are given in compensator toattain the stability of EMG voltage. For applying the PID control system, the SIMULINK block diagram is modified as shown in Fig. 9.
Figure 9.
Block diagram of EMG signal via human finger after applying PID control system
Thereafter, the model is again simulated in MATLAB software, upon which, the data from finger muscles shows the all zero-poles in left hand side of real axis which satisfies the Nyquist criteria shown in Fig. 10. The final EMG voltage VEMGfinal (s) is acquired as given below,
Also, GCF (1rad/s) is less than PCF (1.34 rad/s). Hence, a stable EMG voltage data is achieved. This filtered EMG signal is stable enough to provide necessary voltage signal across the IPMC for proper functioning during operation. The major advantage of this control system is that it is stable with least amount of noise. This signal is sent to artificial muscle finger for holding the object.
Figure 10.
Root-locus and bode plot behaviour of EMG signal via finger through PID controller (Jain et al., 2011)
4. Experimental testing setup
In order to examine the bio-mimetic behaviour of IPMC based artificial muscle finger through EMG signal, EMG electrodes (Ag/Agcl based) are positioned at EDC and EIP muscles on the index finger. The input EMG signal from the muscle movement varies in the range of 1.2mV (which is observed through oscilloscope). But activation of IPMC based artificial muscle finger needs the voltage of 3V and current rating of 50-200 mA which is only possible by amplification of voltage and current. For desired output voltage to the artificial muscle finger, EMG signal is transferred through analog-digital convertor (ADC) card and PXI system (PXI-1031 along with NI-6289) in real time environment. EMG signal through electrodes are sent to an input channel at specified ports of the ADC card. Then this signal is amplified through amplification factor of 2550 using express VI of Labview 8.5 and sent to DAC output. But DAC output signal cannot provide enough current (50-200 mA) to drive an IPMC based artificial muscle finger. For achieving this current rating, the current amplification is done using customized IPMC control circuit by combining operational amplifier (Model: LM-324), transistor (Model: TIP 122) and resistances (1k and 10). Noise interference is eliminated by enabling low-pass filtering with PID control system to achieve the stability during operation of the artificial muscle finger as shown in Fig. 11. The IPMC size 40mm 10 mm 0.2 mm is used for testing purpose.
Now, in order to prevent the abrupt physio-chemical change of the IPMC nature and subsequent shortening of the actuation operating time of the IPMC material due to irreversible electrolysis (caused when the voltage applied across the two faces of an IPMC exceeds a maximum limit), two warning flags are used. One warning flag is placed at input EMG signal and another warning flag is placed at output voltage of DAC card where IPMC control circuit is connected. This limited voltage imposed on the IPMC based artificial muscle finger aborts the execution of the program when the warning flag has a high output. The flow chart for actuation of IPMC based artificial muscle finger is shown in Fig. 12.During operation, artificial muscle finger bends in a similar manner as that of the index finger. For generating force, this finger is held in cantilever configuration on the fabricated work bench. Aload cell is used to collect the data at different angles of the index finger. The current and voltage analysis of the human muscles are also done through oscilloscope. Thus an IPMC artificial muscle finger based micro gripper driven by EMG is developed and the holding behaviour is demonstrated.
Figure 11.
Basic testing layout for actuation of IPMC based artificial muscle finger
5. Results and discussion
During experimentation, the input parameter from muscle ranging from ±1.2 mV is taken through referenced single-ended (RSE) signal along with continuous sampled pulses. Thesepulses are amplified with the help of a PXI system (amplification factor 2550). The desiredoutput voltage range is generated through a DAC output port. The output signal is connected to IPMC based artificial muscle finger. Due to amplified output voltage from the DAC, an IPMC strip bends in one direction for holding the object. By changing the movement of human finger in an opposite direction, reverse behaviour of IPMC is obtained. The characteristics of IPMC based artificial muscle finger are traced on a graph paper and plotted as shown in Fig. 13. It shows that IPMC based artificial muscle finger gives similar bending behaviour as a human finger (Fig. 14). It is also observed that the deflection of IPMC based artificial muscle finger changes with voltage upto 12 mm in one direction. When this finger moves reverse direction, the characteristic of artificial finger does not attempt the same behaviour. It shows the error between two paths is 0.5 mm. The deflection characteristic of IPMC based artificial muscle finger () in term of voltage (V) with cubic behaviour for holding is given below,
δ(V)=0.67×V3-1.9×V2+3.7×V -0.17(in mm)E9
Figure 12.
Flow chart of for actuationIPMC based artificial muscle finger using EMG signal
Figure 13.
Deflection behaviour of IPMC based artificial muscle finger with different voltages
Figure 14.
Control of IPMC based article muscle finger through EMG signal (Jain et al., 2011)
Figure 15.
Load test setup for IPMC based artificial muscle finger using load cell
For generating force by the artificial muscle finger, a testing setup with load cell is used. The IPMC based artificial muscle finger is placed in cantilever mode, and a load cell is placed under the tip of the IPMC which produces the reactive force. When human finger moves downward, the generated force by IPMC artificial muscle finger increases accordingly in the load cell as shown in Fig. 15.
By controlling the movement of human finger, the generated force varies accordingly. The generated force characteristic with voltage shows a cubic polynomial behaviour as shown in Fig. 16 when IPMC artificial muscle finger touches the load cell. This happens due to compliant behaviour of IPMC. The generated force (F)by IPMC based artificial muscle finger in term of voltage (V) is given below,
F(V)=0.11×V3+0.25×V2+1.6×V-0.11(in mN)E10
Figure 16.
Generated force by IPMC based artificial muscle finger at tip with voltage
The maximum generated force of 10 mN is achieved by IPMC based artificial muscle finger at 450 angle of index finger with cubic polynomial behaviour as shown in Fig. 17. This happens due to human finger behaviour where EIP and EDC muscles are connected with DIP and PIP joints. The generated force (F)by IPMC based artificial muscle finger at tip in term of human finger angle () is also obtained as under
For observing the real time IPMC based artificial muscle finger behaviour with moving human finger angle, experiments are conducted and data are plotted as shown in Fig. 18 and it shows almost proportional behaviour with quadratic relationship. This occurs due to human finger behaviour where EIP and EDC are connected with IO and LU muscles (Fig. 3). The relationship between IPMC based artificial muscle finger displacement () and human finger angle () is given below,
δ(θ) = - 0.0016×θ2+ 0.34×θ−0.15(inmm)E12
Figure 17.
Generated force by IPMC based artificial muscle finger with human finger angle
Figure 18.
Relationship between IPMC based artificial muscle finger and human finger angle
For actuation of IPMC based artificial muscle finger, the analysis of activated muscles is carried out as given in Table 1. We have analysed different conditions during contraction of different muscles of index finger like intrinsic and extrinsic which are responsible for actuation of IPMC based artificial muscle finger so that they can be used to hold an object.
Cases
Intrinsic muscles
Extrinsic muscles
State
Polarity
IO 1
IO 2
LU
EDC
EIP
FDS
FDP
Side A
Side B
1
OFF
OFF
OFF
OFF
OFF
OFF
OFF
None
None
None
2
ON
OFF
ON
OFF
OFF
ON
ON
Adduction
+ive
-ive
3
OFF
ON
ON
ON
ON
OFF
OFF
Abduction
-ive
+ive
4
ON
ON
ON
ON
ON
ON
ON
None
None
None
Table 1.
Analysis of different condition of muscles
The two surfaces of IPMC are denoted as side A and side B. In case of intrinsic muscles, the adduction is possible. When IO 1 or IO 2 are in either “on” or “off” condition along with LU muscle in “on” condition then it shows the abduction state. In case of extrinsic muscles, EDC and EIP muscles both are in “off” condition to achieve the adduction state when FDS and FDP muscles both are in “on” condition and for attaining the abduction state EDC and EIP both are in “on” condition when FDS and FDP both are in “off” condition. In rest cases, no power is achieved. Therefore, IPMC based artificial muscle finger is activated in above mentioned conditions from muscles.
The voltage characteristic behavior is taken from EMG and fed to IPMC based artificial muscle finger for actuation in real time environment as shown in Fig. 19. It is found that the trend of IPMC actuation voltage is similar to EMG voltage with amplification factor.
Figure 19.
Different voltage responses in real time environment
The EMG voltage VEMG (t) and IPMC actuation voltage VIPMC actuation (t) equations are respectively given below,
VEMG(t)=∑V0Esin(2πf0Et+δ0E),
0≤t≤0.1E13
and VIPMCactuation(t)=∑V0Isin(2πf0It+δ0I),
0≤t≤0.1E14
Where, V0E is average value of EMG voltage (V); f0E is EMG frequency range (Hz) ; t is signal sample time (s) ; 0E is phase difference when signal is taken through EMG (rad); V0I is average value of IPMC actuation voltage (V); f0I is IPMC actuation frequency range (Hz); 0I is phase difference when signal is given to IPMC (rad). For finding the frequency range of each signal, the experimental data are taken and solved through MATLAB curve fitting tool. The numerical values are V0E= 0.0014510.0002707 V, f0E= 4.70.006201 Hz, 0E= -1.7360.036 rad, V0I= 2.4930.208, f0I= 48.50.65 and 0I= -10.57320.6556 rad. From these data, it is found that EMG frequency range (f01) is similar to simulated data and IPMC actuation frequency range is 48.50.65 Hz which is in between human muscle frequency range (48-52Hz).
Figure 20.
IPMC based artificial muscle finger based micro gripper driven by EMG
After these analyses, an IPMC artificial muscle finger based micro gripper is developed which is driven by EMG as shown in Fig. 20 where one IPMC based artificial muscle finger and other plastic based finger are fixed with double sided tape within one holder. The IPMC based artificial muscle finger is connected through copper tape and wire with EMG sensor so that an IPMC based artificial muscle finger is activated by EMG signal via human finger. The packing tape is also placed on the tip of IPMC based artificial muscle finger so that this finger perfectly holds the object like micro pin for assembly. After these observations, it is understood that IPMC finger behaves as an artificial muscle and this characteristic is implemented in the development of IPMC artificial muscle finger based micro gripper for holding the object through EMG. The major advantages of EMG-driven IPMC based artificial muscle finger are low voltage in man-machine interface, large bending amplitude and simple control that are applied in development of micro/bio robot.
6. Conclusion
In order to develop the micro/bio-mimetic robot for micro assembly, the potential of an EMG driven artificial finger is discussed in this chapter. An artificial finger for micro assembly is designed using IPMC where IPMC is used as an active artificial finger for holding the object. An IPMC has several advantages such as actuating through a small voltage (3 V), light in weight, flexible in nature and does not involve sophisticated controllers for operation. For activating the IPMC based artificial finger, voltage is taken from human index finger through EMG sensor instead of battery source as this is used as a man-machine interface device. Principally, EMG sensor acquires the signal from body during expansion or contraction of muscles. These movements are transferred into an IPMC based artificial muscle finger. For achieving the stable data from EMG, different configurations of control methods are analysed. A PID control system is implemented for attaining the noiseless and stable signal from the user’s myoelectric signal. While acquiring the data, a differential amplification technique is applied where data is filtered through a band pass filter and noise is eliminated through three band stop filters. For sending this signal to the IPMC, an algorithm has been developed in Labview software which gives emphasis on following points:
Acquire voltage data (1.2mV) from human index finger using EMG sensor through data acquisition system
Amplify the continuous EMG signal through DAQ assistant enabling the filter and domain frequency range options
Activate IPMC finger through amplified data (3V) using interface device for functioning as artificial muscle finger
Experimentally, it is demonstrated that IPMC based artificial muscle finger is capable of adopting this voltage from EMG signal and mimics as a human finger. From application point of view, an IPMC artificial finger based micro gripper is developed and its capability is also verified. Through this demonstration, it is proved that IPMC can be activated through EMG signal and is applicable as flexible and compliant finger for holding the object in the fields of micro manipulation. IPMC based artificial muscle could also be a replacement of an electro-mechanical system like electric motors in the application field of rehabilitation technology.
7. Future direction
In future, we will focus on developing well equipped EMG driven micro robotic system where IPMC based micro robotic arm along with multiple IPMC artificial fingers will be used. IPMC based micro robotic arm will be operated through human fore arm movement for lifting and manipulation. Multiple IPMC fingers will be used for robust application like grasping, holding and mimicking of a human hand. Therefore, this new generation of robotic system can be really operated in real world through humans using EMG signals.
Acknowledgement
The authors are grateful to the Director, Central Mechanical Engineering Research Institute (CMERI), Durgapur, West Bengal, India for providing the permission to publish this book chapter.This work is financially supported by the Council of Scientific and Industrial Research (CSIR), New Delhi, India under eleventh five year plan on “Modular Re-configurable Micro Manufacturing System (NWP-30)”.
Design of Mechanical System Group/Micro Robotics Laboratory, CSIR-Central Mechanical Engineering Research Institute (CMERI), Durgapur, West Bengal, India
Design of Mechanical System Group/Micro Robotics Laboratory, CSIR-Central Mechanical Engineering Research Institute (CMERI), Durgapur, West Bengal, India
Design of Mechanical System Group/Micro Robotics Laboratory, CSIR-Central Mechanical Engineering Research Institute (CMERI), Durgapur, West Bengal, India
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1. Introduction
The pes anserinus (PA), which means “Goose foot” in Latin, consists of the conjoined tendon of the sartorius, gracilis, and semitendinosus muscles. It inserts into the proximal anteromedial aspect of the tibia approximately 5 cm distal to the medial tibial joint line. Biomechanically, it provides secondary restraint against valgus forces of the knee joint [1, 2, 3, 4]. The PA bursa (PAB) is located deep to the PA tendon and serves to reduce friction between three tendons and the deep structures including the tibia and the medial collateral ligament (MCL). Commonly, it does not communicate with the knee joint space [3].
The first description of the region in literature dates back to 1937. Moschcowitz described knee pain almost exclusively in women who complained of pain when going downstairs or upstairs, or had difficulty in getting up from a chair, or flexing their knees [5]. PA bursitis or tendinitis, or also called PA tendinobursitis (PATB), is usually used to describe the inflammatory condition of the PAB mainly caused by repetitive friction over the bursa or by direct trauma. It can be observed in patients with rheumatoid arthritis, osteoarthritis (OA), and diabetes mellitus. The risk increases in people who are obese or have valgus knee deformity [6, 7, 8]. PATB is clinically common in obese female OA patients. The distinction between PA bursitis and tendinitis is difficult because of the proximity of the structures. In addition, its pathology remains unknown and is still controversial. However, the treatment strategy is similar for those conditions [9].
The exact prevalence of PATB is unknown. It has been reported at a wide range of levels, between 2.5 and 70% [10]. Frequently, the incidence tended to be underestimated due to difficulty in diagnosis. In a retrospective review of 509 knee MRIs obtained on 488 patients with suspected “internal derangement” at an orthopedic outpatient clinic, a 2.5% prevalence of PATB was detected [11]. Sometimes, fluid collection in semimembranosus bursa, around the collateral ligament, or meniscal cyst can make the differential diagnosis difficult. Therefore, it was suggested that fluid collection in the PA bursa accompanied by clinical symptoms such as pain in the medial side of the knee was helpful for diagnosis. In a prospective study, a total of 170 knees of 85 patients with OA were assessed with the US, and the incidence of PA bursitis was 20% [12]. They presented that PA bursitis was more common in women and at advanced ages and was observed in one of every symptomatic OA patient.
The clinical diagnosis of PATB is based on symptoms, including pain in the medial aspect of the knee when going downstairs or upstairs, morning pain and rigidity for more than 1 h, sensitivity to compression on the tendon insertion area, and occasional local edema [11]. Resolving the pain after a local anesthetic injection may also be helpful for diagnosis [12]. MRI can be useful in the diagnosis of PATB when swelling, fluid collection associated with the inflammatory process are observed as like most of the soft tissue pathologies. The exam can be a good method to detect and differentiate cystic lesion within and around the knee [13]. However, results of the image often do not allow to identify structures that are responsible for the symptoms of PATB.
2. Significance of US-guided injections
Many studies have researched the accuracy and efficacy of US-guided injections compared to blind (without a guide) techniques. Gilliland et al. [14] presented a systemic review about the efficacy of US-guided intra-articular and periarticular injection compared with anatomic standard injection using palpation/anatomic landmarks in the joints of the knee, shoulder, foot, ankle, wrist, and hand. They concluded that accuracy was improved with the use of US-guided injection and short-term outcome improvements were found in the US-guided groups. Berkoff et al. [15] reviewed the clinical utility of US-guided intra-articular knee injections in comparison with palpation-guided anatomical injections. The study suggested that US guidance significantly improved the accuracy of injection in the target joint space. The accuracy induced the improvement of clinical outcomes and cost-effectiveness.
PAB injection is usually performed by a blind method in actual clinical settings because the structure locates close to the superficial layer relative to the shoulder or knee joint. Therefore, it has not been sufficiently studied in relation to the ultrasound (US) guidance. Finnoff et al. [10] compared the accuracy of US-guided and unguided PAB injections in 24 cadaveric lower extremities specimens. The accuracy rate was 92% in the US-guided group and 17% in the unguided group. In spite of the superficial location, most unguided PAB injections failed to place the injectate within the bursa, while US-guided injection showed a high degree of accuracy. Because it was a study using cadavers, therapeutic efficacy in clinical conditions could not be identified. The exact pathology of PATB is still not completely known, which has been studied for more than 80 years. Furthermore, the injection location to prove its effect has not been sufficiently investigated.
This study was conducted with the aim of assessing the accuracy of US-guided PAB injections and evaluating the clinical outcomes of the efficacy of injection by comparing them to blind injections. The study also examined whether the location of injectate could suggest the main source of pain.
3. Methods and materials
3.1 Participants
Patients who were clinically diagnosed with PATB were recruited. Symptoms were determined to include medial knee pain when going downstairs or upstairs, rigidity for more than 1 h, sensitivity to compression on the tendon insertion area, and occasional local edema. All participants were randomly assigned into two groups—the US-guided injection group and the blind injection group. The randomization and allocation sequences were generated by using Microsoft Excel. Seven patients were dropped out to follow-up, and a total of 47 patients were finally analyzed (Figure 1). Patients who had knee OA (grade I–III Kellgren-Lawrence), pain in the medial aspect of the knee, and symptoms lasting for at least 3 months were included. These patients presented maximal tenderness over the PAB, not on the joint line or around the patella bone. The exclusion criteria were history of traumatic injury or mechanical derangement, surgical intervention, systemic inflammatory disorders, concomitant severe rheumatic disease, microcrystalline arthropathy, or fibromyalgia.
Figure 1.
Study flowchart.
The study was carried out with permission from the institutional review board of our hospital. Informed consent was obtained from each subject for study participation, according to the ethical guidelines of the hospital after the subject fully understood the study’s purpose and methodology.
3.2 US-guided injection technique
All sonographic examinations and injections were performed by one expert physician with over 10 years of experience in the musculoskeletal US and managing knee OA. In the preparation, the subjects were placed in the supine position with the knee flexed 5-10 degrees. After marking the PAB area, the skin was prepped with the usual products. US assessment was performed on the medial part of the knee using a linear array probe with a 6–12-MHz frequency and penetration depths of 2.5–4 cm. The needle was inserted at the point where the PA crossed over the anterior fibers of the MCL. The transducer was positioned in a longitudinal orientation relative to the anterior fibers of the MCL, with an oblique transverse orientation relative to the PA. Under US guidance, a 25-gauge 38-mm needle was inserted through the skin proximal to the transducer in a longitudinal plane. Continuously advanced in the distal direction and introduced the needle tip into the tissue space between the PA and the MCL. When the needle tip was visualized between the middle of the PA and the MCL, the materials were injected under direct sonographic visualization (Figures 2 and 3).
Figure 2.
US-guided injection, the transducer was positioned in a longitudinal orientation relative to the anterior fibers of the medial collateral ligament, with an oblique transverse orientation relative to the pes anserinus.
Figure 3.
US-guided injection, longitudinal ultrasound image of a needle (arrowhead) in the pes anserinus bursa (asterisk) between the medial collateral ligament (MCL) and the pes anserinus (PA) tendon.
3.3 Blind injection technique
The same physician who carried out US-guided injections provided the blind injections. The blind injection was performed in a similar technique to the method described previously [16]. The subjects were placed in the supine position, with the slightly flexed knee as like for the US-guided methods; palpated the point of maximal tenderness and marked it; prepped the skin using a usual product; inserted the 25-gauge 38-mm needle to the skin perpendicularly into the maximal tender point until touching the bone gently. After that, the needle of 2–3 mm is withdrawn to avoid injecting into the conjoined tendon directly; the materials are injected into the syringe, which should easily flow.
3.4 Injection material
The injection material was a mixture of 20 mg of triamcinolone acetonide and 1 mL of 1% lidocaine. It was injected at the maximal tender point in the PAB area under US guidance and blind method each. After the PA injections, to identify the location of the material, sonographic scanning was performed in both groups.
3.5 Assessment
After the management, the accuracy of the injections was assessed by identifying the injectate location using the US. The injectate location was evaluated by a second operator who was unaware of the previous procedure with more than 8 years of musculoskeletal US experience in diagnosis and management.
Treatment efficacy to the injection was assessed with a pain visual analog scale (VAS) of knee tenderness. The patients were asked to check the degree of pain intensity ranging from 0 (the absence of pain) to 10 (the worst pain ever). Because all the participants in this study had degenerative arthritis of the knees, it was important to distinguish between articular pain and bursal pain. If the patients described it as simply knee pain, the distinction could be confusing. Therefore, the VAS scores were measured while the constant force was applied to the tender point of PA by an examiner with a pressure algometer (FPK-5®Wagner Instruments, USA). This measurement was performed before 1 week and 4 weeks after the injection.
We did not provide any drugs which had the analgesic effect, including nonsteroidal anti-inflammatory drugs that could mask the pain symptoms of the participants. All patients were informed about discomforts after injection. To avoid possible tendon tear or rupture, the patients were advised to rest for at least 2–3 days with the application of ice 3 times every day. Also, they were taught not to do jumping, squatting, kneeling, and bending of the knee for 3 weeks. About 4 weeks after the procedures, complications that had occurred were assessed by individual interviews.
The data were analyzed by using Windows SPSS 18.0 software. To evaluate the outcome measurements before and after treatment in each group, the Wilcoxon signed-rank test was used. Statistical processing was conducted with the Mann-Whitney U test for comparison between the two groups. A statistical significance level was set at p < 0.05.
4. Results
Forty-seven patients diagnosed with PATB and knee OA were finally recruited. The US-guided injection group included 25 patients with a mean age of 65.36 ± 7.12 years (two men and 23 women). The blind injection group included 22 patients with a mean age of 63.40 ± 6.20 years (two men and 20 women). There were no significant differences in general characteristics including knee OA K-L grade, and baseline VAS scores between the two groups (Table 1).
US-guided group
Blind group
p value
Age (year)
65.36 ± 7.12
63.40 ± 6.20
0.412
Sex (male/female)
2/23
2/20
Right/left
11/14
12/10
Knee OA duration (year)
7.21 ± 6.33
6.35 ± 6.24
0.137
Knee OA K-L grade
2.20 ± 0.56
2.15 ± 0.57
0.652
Baseline pain score
VAS (knee pain)
5.24 ± 1.20
4.80 ± 1.45
0.255
VAS (PA tenderness)
6.82 ± 1.45
6.45 ± 1.12
0.320
Table 1.
Baseline characteristics of both groups.
Values are presented as mean ± standard deviation.
US = ultrasound; OA = osteoarthritis; K-L grade = Kellgren-Lawrence grade; VAS = visual analog scale; PA = pes anserinus.
In the US-guided injection group, changes of the VAS for PA tenderness showed that pain reduced significantly from 6.82 ± 1.45 at baseline to 2.28 ± 1.08 1 week after the injection and 3.27 ± 0.94 4 weeks after the injection (p < 0.05) (Table 2). In the blind injection group, changes of the VAS also revealed that pain reduced statistically from 6.45 ± 1.12 at baseline to 3.95 ± 1.23 1 week after the injection and 4.60 ± 0.95 4 weeks after the injection (p < 0.05) (Table 2).
Changes of VAS of PA tenderness comparing baseline.
p < 0.05 by Wilcoxon signed-rank test.
Values are presented as mean ± standard deviation.
VAS = visual analog scale; PA = pes anserinus; US = ultrasound.
Table 3 shows the comparison between the two groups in changes of the VAS score for PA tenderness. The US-guided injection group showed that pain reduced significantly greater than the blind group with regard to ΔVAS scores at 1 week after injection (4.54 ± 0.98 vs. 2.50 ± 1.03) and 4 weeks after injection (3.55 ± 1.14 vs. 1.85 ± 0.84).
Changes of VAS of PA tenderness between two groups.
p < 0.05 by Mann-Whitney U test.
Values are presented as mean ± standard deviation.
VAS = visual analog scale; US = ultrasound.
After the PAB injections, the injectates were found to be accurate in the PAB, between the PA tendon and the tibia or the MCL, in all 25 subjects in the US-guided injection group (Figure 4). On the other hand, in the blind injection group the materials were found to be located in the PAB in only four of 22 subjects, deep to the MCL in two, and superficial to the PA tendon in 16 patients (Figure 5). Most injectates were administered outside the PA bursa.
Figure 4.
Ultrasound image of the injectate location after injection; intra-pes anserinus bursa area.
Figure 5.
Ultrasound image of the injectate location after injection; extra-pes anserinus bursa area, the injection was superficial to the tendon.
Intra-tendon injection was not performed on any of the participants in either group. Complications were not reported after the intervention in both groups.
5. Discussion
The US is widely used for diagnosis and treatment in musculoskeletal fields. There have been several studies representing US features of PA tendon or PAB in patients with PATB. Some studies reported that the US is limited in detecting PATB, while others concluded that it can be helpful. Uson et al. [17] assessed the US findings of the PA and the subcutaneous fat of medial knee in clinically diagnosed PATB patients. The diagnostic findings were the thickness of the insertion of the tendons, the presence of fluid collection greater than 2 mm in the bursa, and changes in the subcutaneous fat of the medial aspect of the knee. For a total of 37 participants, PA tendinitis was diagnosed in just one knee and PA bursitis in three knees (two symptomatic and one asymptomatic). From the results, they concluded that it was difficult to detect US findings of PA tendinitis or bursitis in patients diagnosed with PATB syndrome. Unlu et al. [18] examined US evidence of PA tendinitis or bursitis in patients with type 2 diabetes mellitus. Only 8.3% of 48 patients were found to have PA tendinitis findings in the US. Although PA tendinitis or bursitis syndrome is not uncommon in patients with diabetes mellitus, there might be less frequent morphologic US changes of the PA tendons. Yoon et al. [2] prospectively studied the correlation between US findings and response to steroid injection in 26 patients with clinically diagnosed PATB syndrome. Only two patients (8.7%) showed sonographic evidence of PATB. One patient with PA tendinitis showed thickening and loss of normal fibrillar echotexture. The other who had bursitis revealed circumscribed anechoic fluid collection of 2 mm or greater.
Uysal et al. [12] evaluated the prevalence of PA bursitis in OA patients. A total of 170 knees from 85 patients with knee OA were assessed, and 20% (34/170) of the knees showed PA bursitis in US examinations. They suggested that PA bursitis was easily found in the US, and there was a positive correlation between OA grade and PAB size and area. Toktas et al. [19] studied the US findings of PA tendon and bursa in 183 clinically diagnosed PATB among the 314 knees with OA. The results showed that the mean thickness of PA in knees with OA with/without PATB was significantly greater than the controls. US could be a useful diagnostic tool for detecting PATB syndrome in knee OA patients.
The term PATB is generally used to describe the inflammatory condition of PAB; however, the structure associated with symptoms is still not identified. After the intervention in our study, all injectates (25 of 25 subjects) were located accurately in the PAB in the US-guided injection group, whereas just 18% (4 of 22 subjects) were properly located in the blind injection group. The US-guided group revealed greater pain reduction significantly than the blind group. This suggests that the pain might be arisen from the bursa, so a diagnosis of tendinobursitis is more suitable for this condition.
As previous studies have shown, US-guided injections are more accurate than blind injections. Various reviews have recently been reported on the clinical utility of US-guided injections in locations such as shoulder girdles, hip joints, and knee joints. A systematic review of US-guided shoulder girdle injections reviewed four cadaveric studies and nine human studies, and concluded that US-guided injections had greater accuracy for all types of shoulder injections than landmark-guided injections, except subacromial injection. The efficacy for the subacromial and biceps tendon sheath injections was improved [20]. Another systematic review of US-guided hip joint injections showed the improvement of accuracy. They reviewed four US-guided and five landmark-guided studies, and suggested that US-guided hip injections were significantly more accurate than landmark-guided techniques [21]. A review of US-guided intra-articular knee injections revealed that US-guided injections notably improved accuracy in the intra-articular joint injections than conventional palpation-guided injections by analyzing a total of 13 previous studies. US guidance also directly improved patient-reported clinical outcomes and cost-effectiveness [15].
PAB injection is usually performed by blind technique in actual clinical settings because PA is located closer to the superficial layer compared to other deep joints. Acromioclavicular joint (AC) is also located superficially, and blind injection is often performed through palpation. Nevertheless, a previous study has shown that the use of US in the AC joint injection is more accurate and effective [22]. They concluded that US-guided AC joint articular injection resulted in better pain and functional status improvement than palpation-guided injection at the 6-month follow-up. Therefore, even in the superficial structures, US-guided injection is recommended for accurate treatment.
For this reason, although the effectiveness of US examination in the PATB diagnosis is controversial, the value of US-guided injection treatment is sufficiently recognized for its accuracy. Overall, the accuracy of blind injections is 40–80%, while that of US-guided injections is approximately 90–100%. In most of these injections, the improved accuracy achieved by US guidance directly enhances clinical outcomes.
Consistent with previous studies, this research observed that US-guided injection was more accurate than the blind injection, and intra-bursal injection had a better clinical result in the treatment of PATB. Although the standardized US-guided injection technique has not yet been established, longitudinal access to the tibia would be appropriate to administer materials. Anatomically, the transducer is positioned in a longitudinal orientation relative to the MCL, oblique transverse access relative to the PA. While monitoring the image, insert the needle through the skin proximal to the transducer and advance in a proximal to the distal direction in a longitudinal plane. According to the physician’s preference, a needle can approach the distal to the transducer and advance in the proximal direction in a longitudinal plane. The target of the injection is the space beneath the PA tendon. When the needle tip is visualized in the target space, inject the materials slowly and carefully, since the space is relatively narrow.
The PAB corticosteroid injections are contraindicated in patients with systemic infection states (sepsis, bacteremia, etc.), joint infection (septic arthritis, cellulitis, osteomyelitis, etc.), fracture, osteoporosis, coagulopathy, skin defect, hypersensitivity to the steroid, uncontrolled hyperglycemia; also, some complications such as bleeding, bruising, swelling, infection, post-injection pain (steroid flare), face flushing, skin depigmentation, cutaneous atrophy can occur [23].
There were several limitations of our study. Because of the short-term follow-up period, the long-term clinical effects could not be determined. The morphologic US features of the anserine bursa or tendon were not examined that might help to identify the source of pain in PATB. In addition, potential differences caused by activity levels were not considered even if they had a potential impact on the results of the study.
6. Conclusion
Both US-guided and blind injections significantly reduced pain levels in patients with PATB. In the US-guided injection group, the accuracy was higher than in the blind injection group. Clinical results were more affected in the US group. All injectates were located in the PAB after the US-guided injections, while only in some cases of the blind approaches, injectates were located in the PAB. This suggests that the optimal source of pain might be associated with the bursa.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"pes anserinus tendinobursitis, bursa injection, ultrasound",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78885.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78885.xml",downloadPdfUrl:"/chapter/pdf-download/78885",previewPdfUrl:"/chapter/pdf-preview/78885",totalDownloads:129,totalViews:0,totalCrossrefCites:0,dateSubmitted:"August 12th 2021",dateReviewed:"September 7th 2021",datePrePublished:"October 14th 2021",datePublished:"May 11th 2022",dateFinished:"October 8th 2021",readingETA:"0",abstract:"The term “pes anserinus tendinobursitis (PATB)” is generally used to describe the inflammatory condition of pes anserinus bursa (PAB). Ultrasound (US) is widely used as a diagnostic and therapeutic tool to improve the assessment and management of joints and soft tissues. We performed the study to prove the accuracy and efficacy of US-guided injections in patients with PATB by comparing blind interventions. Forty-seven patients were randomly assigned to an US-guided and a blind injection group. The patients in the US-guided group were given injections under sonographic visualization. Otherwise, in the blind group, injections were provided in the conventional technique without any sonographic guidance. After the management, the accuracy of the injections was assessed by identifying the injectate location using the US. Treatment efficacy was evaluated using the visual analog scale (VAS) of knee tenderness. The US-guided group showed that the injectates were located at the PAB accurately in all participants, whereas the blind group revealed that the materials were found to be at the bursa side only in 4 out of 22 patients. VAS scores of the US-guided group significantly improved compared to the blind group. In conclusion, US-guided PAB injections are more accurate and efficacious than blind approaches.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78885",risUrl:"/chapter/ris/78885",signatures:"Jong Hwa Lee, Jae Uk Lee and Seung Wan Yoo",book:{id:"10870",type:"book",title:"Ultrasound Imaging",subtitle:"Current Topics",fullTitle:"Ultrasound Imaging - Current Topics",slug:"ultrasound-imaging-current-topics",publishedDate:"May 11th 2022",bookSignature:"Felix Okechukwu Erondu",coverURL:"https://cdn.intechopen.com/books/images_new/10870.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-78985-186-1",printIsbn:"978-1-78984-877-9",pdfIsbn:"978-1-78985-331-5",isAvailableForWebshopOrdering:!0,editors:[{id:"68312",title:"Prof.",name:"Felix",middleName:null,surname:"Okechukwu Erondu",slug:"felix-okechukwu-erondu",fullName:"Felix Okechukwu Erondu"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"420763",title:"Prof.",name:"jong hwa",middleName:null,surname:"lee",fullName:"jong hwa lee",slug:"jong-hwa-lee",email:"jhlee08@dau.ac.kr",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"429100",title:"Dr.",name:"Jae Uk",middleName:null,surname:"Lee",fullName:"Jae Uk Lee",slug:"jae-uk-lee",email:"l66gd@hanmail.net",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"429101",title:"Dr.",name:"Seung Wan",middleName:null,surname:"Yoo",fullName:"Seung Wan Yoo",slug:"seung-wan-yoo",email:"l66rmgd@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Significance of US-guided injections",level:"1"},{id:"sec_3",title:"3. Methods and materials",level:"1"},{id:"sec_3_2",title:"3.1 Participants",level:"2"},{id:"sec_4_2",title:"3.2 US-guided injection technique",level:"2"},{id:"sec_5_2",title:"3.3 Blind injection technique",level:"2"},{id:"sec_6_2",title:"3.4 Injection material",level:"2"},{id:"sec_7_2",title:"3.5 Assessment",level:"2"},{id:"sec_9",title:"4. Results",level:"1"},{id:"sec_10",title:"5. Discussion",level:"1"},{id:"sec_11",title:"6. Conclusion",level:"1"},{id:"sec_15",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Helfenstein M Jr, Kuromoto J. Anserine syndrome. Revista Brasileira de Reumatologia. 2010;50:313-327'},{id:"B2",body:'Yoon HS, Kim SE, Suh YR, Seo YI, Kim HA. Correlation between ultrasonographic findings and the response to corticosteroid injection in pes anserinus tendinobursitis syndrome in knee osteoarthritis patients. Journal of Korean Medical Science. 2005;20:109-112. DOI: 10.3346/jkms.2005.20.1.109'},{id:"B3",body:'Marra MD, Crema MD, Chung M, Roemer FW, Hunter DJ, Zaim S, et al. MRI features of cystic lesions around the knee. The Knee. 2008;15:423-438. DOI: 10.1016/j.knee.2008.04.009'},{id:"B4",body:'Handy JR. Anserine bursitis: A brief review. Southern Medical Journal. 1997;90:376-377. DOI: 097/00007611-199704000-00002'},{id:"B5",body:'Moschcowitz E. Bursitis of sartorius bursa, an undescribed malady simulating chronic arthritis. Journal of the American Medical Association. 1937;109:1362-1366. DOI: 10.1001/jama.1937.92780430001009'},{id:"B6",body:'Kang I, Han SW. Anserine bursitis in patients with osteoarthritis of the knee. Southern Medical Journal. 2000;93:207-209'},{id:"B7",body:'Brookler MI, Mongan ES. Anserine bursitis, a treatable cause of knee pain in patients with degenerative arthritis. California Medicine. 1973;119:8-10'},{id:"B8",body:'Cohen SE, Mahul O, Meir R, et al. Anserine bursitis and noninsulin dependent diabetes mellitus. The Journal of Rheumatology. 1997;24:2162-2165'},{id:"B9",body:'Klippel JH. Primer on the Rheumatic Diseases. Musculoskeletal Signs and Symptoms—Regional Rheumatic Pain Syndromes— Disorders of the Knee Region. 12th ed. Arthritis Foundation, New York: Springer; 2001. p. 182. DOI: 10.1007/978-0-387-68566-3'},{id:"B10",body:'Finnoff JT, Nutz DJ, Henning PT, Hollman JH, Smith j. Accuracy of ultrasound-guided versus unguided pes anserinus bursa injections. PM & R: The Journal of Injury, Function, and Rehabilitation. 2010;2:732-739. DOI: 10.1016/j.pmrj.2010.03.014'},{id:"B11",body:'Rennie WJ, Saifuddin A. Pes anserine bursitis: Incidence in symptomatic knees and clinical presentation. Skeletal Radiology. 2005;34:395-398. DOI: 10.1007/s00256-005-0918-7'},{id:"B12",body:'Uysal F, Akbal A, Gökmen F, Adam G, Reşorlu M. Prevalence of pes anserine bursitis in symptomatic osteoarthritis patients: An ultrasonographic prospective study. Clinical Rheumatology. 2015;34:529-533. DOI: 10.1007/s10067-014-2653-8'},{id:"B13",body:'Koh WL, Kwek JW, Quek ST, Peh WCG. Clinics in diagnostic imaging. Singapore Medical Journal. 2002;43:485-491'},{id:"B14",body:'Gilliland CA, Salazar LD, Borchers JR. Ultrasound versus anatomic guidance for intra-articular and periarticular injection: A systematic review. The Physician and Sportsmedicine. 2011;39:121-131. DOI: 10.3810/psm.2011.09.1928'},{id:"B15",body:'Berkoff DJ, Miller LE, Block JE. Clinical utility of ultrasound guidance for intra-articular knee injections: A review. Clinical Interventions in Aging. 2012;7:89-95. DOI: 10.2147/CIA.S29265'},{id:"B16",body:'Brock G, Gurekas V. The occasional pes anserinus bursitis injection. Canadian Journal of Rural Medicine. 2014;19:71-73'},{id:"B17",body:'Uson J, Aguado P, Bernad M, Mayordomo L, Naredo E, Balsa A, et al. Pes anserinus tendino-bursitis: What are we talking about? Scandinavian Journal of Rheumatology. 2000;29:184-186. DOI: 10.1080/030097400750002076'},{id:"B18",body:'Unlu Z, Ozmen B, Tarhan S, Boyvoda S, Goktan C. Ultrasonographic evaluation of pes anserinus tendino-bursitis in patients with type 2 diabetes mellitus. The Journal of Rheumatology. 2003;30:352-354'},{id:"B19",body:'Toktas H, Dundar U, Adar S, Solak O, Ulasil AM. Ultrasonographic assessment of pes anserinus tendon and pes anserinus tendinitis bursitis syndrome in patients with knee osteoarthritis. Modern Rheumatology. 2015;25:128-133. DOI: 10.3109/14397595.2014.931909'},{id:"B20",body:'Aly AR, Rajasekaran S, Ashworth N. Ultrasound-guided shoulder girdle injections are more accurate and more effective than landmark-guided injections: A systematic review and meta-analysis. British Journal of Sports Medicine. 2015;49:1042-1049. DOI: 10.1136/bjsports-2014-093573'},{id:"B21",body:'Hoeber S, Aly AR, Ashworth N, Rajasekaran S. Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: A systematic review and meta-analysis. British Journal of Sports Medicine. 2016;50:392-396. DOI: 10.1136/bjsports-2014-094570'},{id:"B22",body:'Park KD, Kim TK, Lee J, Lee WY, Ahn JK, Park Y. Palpation versus ultrasound-guided acromioclavicular joint intra-articular corticosteroid injections: A retrospective comparative clinical study. Pain Physician. 2015;18:333-341'},{id:"B23",body:'Simurina T, Mraovic B, Zupcic M, Zupcic SG, Vulin M. Local anesthetics and steroids: Contraindications and complications-clinical update. Acta Clinica Croatica. 2019;58:53-61'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Jong Hwa Lee",address:"jhlee08@dau.ac.kr",affiliation:'
Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Republic of Korea
'},{corresp:null,contributorFullName:"Jae Uk Lee",address:null,affiliation:'
Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Republic of Korea
'},{corresp:null,contributorFullName:"Seung Wan Yoo",address:null,affiliation:'
Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Republic of Korea
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Based on your preferences and the stage of your scientific projects, you have multiple options for publishing your scientific research with IntechOpen:
The Open Access publishing model followed by IntechOpen eliminates subscription charges and pay-per-view fees, thus enabling readers to access research at no cost to themselves. In order to sustain these operations, and keep our publications freely accessible, we levy an Open Access Publishing Fee on all manuscripts accepted for publication to help cover the costs of editorial work and the production of books.
Based on your preferences and the stage of your scientific projects, you have multiple options for publishing your scientific research with IntechOpen:
The Open Access publishing model followed by IntechOpen eliminates subscription charges and pay-per-view fees, thus enabling readers to access research at no cost to themselves. In order to sustain these operations, and keep our publications freely accessible, we levy an Open Access Publishing Fee on all manuscripts accepted for publication to help cover the costs of editorial work and the production of books.
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\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
\r\n
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\r\n
\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n
\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
\r\n
\r\n\t
\r\n
\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
\r\n
\r\n\t
\r\n
\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
\r\n
\r\n\t
\r\n
\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
\r\n
\r\n\t
\r\n
\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
\r\n
\r\n\t
\r\n
\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
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He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNVJQA4/Profile_Picture_2022-03-07T13:23:04.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. His research interests include biochemistry, oxidative stress, reactive species, antioxidants, lipid peroxidation, inflammation, reproductive hormones, phenolic compounds, female infertility.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Associate Prof.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/15648_n.jpg",biography:"Dr. Mohd Aftab Siddiqui is currently working as Assistant Professor in the Faculty of Pharmacy, Integral University, Lucknow for the last 6 years. He has completed his Doctor in Philosophy (Pharmacology) in 2020 from Integral University, Lucknow. He completed his Bachelor in Pharmacy in 2013 and Master in Pharmacy (Pharmacology) in 2015 from Integral University, Lucknow. He is the gold medalist in Bachelor and Master degree. He qualified GPAT -2013, GPAT -2014, and GPAT 2015. His area of research is Pharmacological screening of herbal drugs/ natural products in liver and cardiac diseases. He has guided many M. Pharm. research projects. He has many national and international publications.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. degree from Integral University. Currently, he’s working as an Assistant Professor of Pharmaceutics in the Faculty of Pharmacy, Integral University. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than 32 original articles published in reputed journals, 3 edited books, 5 book chapters, and a number of scientific articles published in ‘Ingredients South Asia Magazine’ and ‘QualPharma Magazine’. He is a member of the American Association for Cancer Research, International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs that aim to provide practical solutions to current healthcare problems.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}},{id:"297507",title:"Dr.",name:"Charles",middleName:"Elias",surname:"Assmann",slug:"charles-assmann",fullName:"Charles Assmann",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/297507/images/system/297507.jpg",biography:"Charles Elias Assmann is a biologist from Federal University of Santa Maria (UFSM, Brazil), who spent some time abroad at the Ludwig-Maximilians-Universität München (LMU, Germany). He has Masters Degree in Biochemistry (UFSM), and is currently a PhD student at Biochemistry at the Department of Biochemistry and Molecular Biology of the UFSM. His areas of expertise include: Biochemistry, Molecular Biology, Enzymology, Genetics and Toxicology. He is currently working on the following subjects: Aluminium toxicity, Neuroinflammation, Oxidative stress and Purinergic system. Since 2011 he has presented more than 80 abstracts in scientific proceedings of national and international meetings. Since 2014, he has published more than 20 peer reviewed papers (including 4 reviews, 3 in Portuguese) and 2 book chapters. He has also been a reviewer of international journals and ad hoc reviewer of scientific committees from Brazilian Universities.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",country:{name:"Brazil"}}},{id:"217850",title:"Dr.",name:"Margarete Dulce",middleName:null,surname:"Bagatini",slug:"margarete-dulce-bagatini",fullName:"Margarete Dulce Bagatini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217850/images/system/217850.jpeg",biography:"Dr. Margarete Dulce Bagatini is an associate professor at the Federal University of Fronteira Sul/Brazil. She has a degree in Pharmacy and a PhD in Biological Sciences: Toxicological Biochemistry. She is a member of the UFFS Research Advisory Committee\nand a member of the Biovitta Research Institute. She is currently:\nthe leader of the research group: Biological and Clinical Studies\nin Human Pathologies, professor of postgraduate program in\nBiochemistry at UFSC and postgraduate program in Science and Food Technology at\nUFFS. She has experience in the area of pharmacy and clinical analysis, acting mainly\non the following topics: oxidative stress, the purinergic system and human pathologies, being a reviewer of several international journals and books.",institutionString:"Universidade Federal da Fronteira Sul",institution:{name:"Universidade Federal da Fronteira Sul",country:{name:"Brazil"}}},{id:"226275",title:"Ph.D.",name:"Metin",middleName:null,surname:"Budak",slug:"metin-budak",fullName:"Metin Budak",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226275/images/system/226275.jfif",biography:"Metin Budak, MSc, PhD is an Assistant Professor at Trakya University, Faculty of Medicine. He has been Head of the Molecular Research Lab at Prof. Mirko Tos Ear and Hearing Research Center since 2018. His specializations are biophysics, epigenetics, genetics, and methylation mechanisms. He has published around 25 peer-reviewed papers, 2 book chapters, and 28 abstracts. He is a member of the Clinical Research Ethics Committee and Quantification and Consideration Committee of Medicine Faculty. His research area is the role of methylation during gene transcription, chromatin packages DNA within the cell and DNA repair, replication, recombination, and gene transcription. His research focuses on how the cell overcomes chromatin structure and methylation to allow access to the underlying DNA and enable normal cellular function.",institutionString:"Trakya University",institution:{name:"Trakya University",country:{name:"Turkey"}}},{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",biography:"Anca Pantea Stoian is a specialist in diabetes, nutrition, and metabolic diseases as well as health food hygiene. She also has competency in general ultrasonography.\n\nShe is an associate professor in the Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. She has been chief of the Hygiene Department, Faculty of Dentistry, at the same university since 2019. Her interests include micro and macrovascular complications in diabetes and new therapies. Her research activities focus on nutritional intervention in chronic pathology, as well as cardio-renal-metabolic risk assessment, and diabetes in cancer. She is currently engaged in developing new therapies and technological tools for screening, prevention, and patient education in diabetes. \n\nShe is a member of the European Association for the Study of Diabetes, Cardiometabolic Academy, CEDA, Romanian Society of Diabetes, Nutrition and Metabolic Diseases, Romanian Diabetes Federation, and Association for Renal Metabolic and Nutrition studies. She has authored or co-authored 160 papers in national and international peer-reviewed journals.",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",country:{name:"Romania"}}},{id:"279792",title:"Dr.",name:"João",middleName:null,surname:"Cotas",slug:"joao-cotas",fullName:"João Cotas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279792/images/system/279792.jpg",biography:"Graduate and master in Biology from the University of Coimbra.\n\nI am a research fellow at the Macroalgae Laboratory Unit, in the MARE-UC – Marine and Environmental Sciences Centre of the University of Coimbra. My principal function is the collection, extraction and purification of macroalgae compounds, chemical and bioactive characterization of the compounds and algae extracts and development of new methodologies in marine biotechnology area. \nI am associated in two projects: one consists on discovery of natural compounds for oncobiology. The other project is the about the natural compounds/products for agricultural area.\n\nPublications:\nCotas, J.; Figueirinha, A.; Pereira, L.; Batista, T. 2018. An analysis of the effects of salinity on Fucus ceranoides (Ochrophyta, Phaeophyceae), in the Mondego River (Portugal). Journal of Oceanology and Limnology. in press. DOI: 10.1007/s00343-019-8111-3",institutionString:"Faculty of Sciences and Technology of University of Coimbra",institution:null},{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279788/images/system/279788.jpg",biography:"Leonel Pereira has an undergraduate degree in Biology, a Ph.D. in Biology (specialty in Cell Biology), and a Habilitation degree in Biosciences (specialization in Biotechnology) from the Faculty of Science and Technology, University of Coimbra, Portugal, where he is currently a professor. In addition to teaching at this university, he is an integrated researcher at the Marine and Environmental Sciences Center (MARE), Portugal. His interests include marine biodiversity (algae), marine biotechnology (algae bioactive compounds), and marine ecology (environmental assessment). Since 2008, he has been the author and editor of the electronic publication MACOI – Portuguese Seaweeds Website (www.seaweeds.uc.pt). He is also a member of the editorial boards of several scientific journals. Dr. Pereira has edited or authored more than 20 books, 100 journal articles, and 45 book chapters. He has given more than 100 lectures and oral communications at various national and international scientific events. He is the coordinator of several national and international research projects. In 1998, he received the Francisco de Holanda Award (Honorable Mention) and, more recently, the Mar Rei D. Carlos award (18th edition). He is also a winner of the 2016 CHOICE Award for an outstanding academic title for his book Edible Seaweeds of the World. In 2020, Dr. Pereira received an Honorable Mention for the Impact of International Publications from the Web of Science",institutionString:"University of Coimbra",institution:{name:"University of Coimbra",country:{name:"Portugal"}}},{id:"61946",title:"Dr.",name:"Carol",middleName:null,surname:"Bernstein",slug:"carol-bernstein",fullName:"Carol Bernstein",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/61946/images/system/61946.jpg",biography:"Carol Bernstein received her PhD in Genetics from the University of California (Davis). She was a faculty member at the University of Arizona College of Medicine for 43 years, retiring in 2011. Her research interests focus on DNA damage and its underlying role in sex, aging and in the early steps of initiation and progression to cancer. In her research, she had used organisms including bacteriophage T4, Neurospora crassa, Schizosaccharomyces pombe and mice, as well as human cells and tissues. She authored or co-authored more than 140 scientific publications, including articles in major peer reviewed journals, book chapters, invited reviews and one book.",institutionString:"University of Arizona",institution:{name:"University of Arizona",country:{name:"United States of America"}}},{id:"182258",title:"Dr.",name:"Ademar",middleName:"Pereira",surname:"Serra",slug:"ademar-serra",fullName:"Ademar Serra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/182258/images/system/182258.jpeg",biography:"Dr. Serra studied Agronomy on Universidade Federal de Mato Grosso do Sul (UFMS) (2005). He received master degree in Agronomy, Crop Science (Soil fertility and plant nutrition) (2007) by Universidade Federal da Grande Dourados (UFGD), and PhD in agronomy (Soil fertility and plant nutrition) (2011) from Universidade Federal da Grande Dourados / Escola Superior de Agricultura Luiz de Queiroz (UFGD/ESALQ-USP). Dr. Serra is currently working at Brazilian Agricultural Research Corporation (EMBRAPA). His research focus is on mineral nutrition of plants, crop science and soil science. Dr. Serra\\'s current projects are soil organic matter, soil phosphorus fractions, compositional nutrient diagnosis (CND) and isometric log ratio (ilr) transformation in compositional data analysis.",institutionString:"Brazilian Agricultural Research Corporation",institution:{name:"Brazilian Agricultural Research Corporation",country:{name:"Brazil"}}}]}},subseries:{item:{id:"18",type:"subseries",title:"Proteomics",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11414,editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",slug:"paolo-iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",biography:"Paolo Iadarola graduated with a degree in Chemistry from the University of Pavia (Italy) in July 1972. He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. He is also Associate Editor of Biotech.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",slug:"simona-viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",biography:"Simona Viglio is an Associate Professor of Biochemistry at the Department of Molecular Medicine at the University of Pavia. She has been working since 1995 on the determination of proteolytic enzymes involved in the degradation process of connective tissue matrix and on the identification of biological markers of lung diseases. She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,series:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983"},editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",slug:"arli-aditya-parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",slug:"cesar-lopez-camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",slug:"shymaa-enany",fullName:"Shymaa Enany",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRqB9QAK/Profile_Picture_1626163237970",institutionString:null,institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]},onlineFirstChapters:{paginationCount:1,paginationItems:[{id:"81644",title:"Perspective Chapter: Ethics of Using Placebo Controlled Trials for Covid-19 Vaccine Development in Vulnerable Populations",doi:"10.5772/intechopen.104776",signatures:"Lesley Burgess, Jurie Jordaan and Matthew Wilson",slug:"perspective-chapter-ethics-of-using-placebo-controlled-trials-for-covid-19-vaccine-development-in-vu",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"SARS-CoV-2 Variants - Two Years After",coverURL:"https://cdn.intechopen.com/books/images_new/11573.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}}]},publishedBooks:{paginationCount:3,paginationItems:[{type:"book",id:"8977",title:"Protein Kinases",subtitle:"Promising Targets for Anticancer Drug Research",coverURL:"https://cdn.intechopen.com/books/images_new/8977.jpg",slug:"protein-kinases-promising-targets-for-anticancer-drug-research",publishedDate:"December 8th 2021",editedByType:"Edited by",bookSignature:"Rajesh Kumar Singh",hash:"6d200cc031706a565b554fdb1c478901",volumeInSeries:24,fullTitle:"Protein Kinases - Promising Targets for Anticancer Drug Research",editors:[{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9742",title:"Ubiquitin",subtitle:"Proteasome Pathway",coverURL:"https://cdn.intechopen.com/books/images_new/9742.jpg",slug:"ubiquitin-proteasome-pathway",publishedDate:"December 9th 2020",editedByType:"Edited by",bookSignature:"Xianquan Zhan",hash:"af6880d3a5571da1377ac8f6373b9e82",volumeInSeries:18,fullTitle:"Ubiquitin - Proteasome Pathway",editors:[{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy 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Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment"},{id:"5",title:"Parasitic Infectious Diseases",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:{title:"Infectious Diseases",id:"6"},selectedSubseries:null},seriesLanding:{item:null},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/334430",hash:"",query:{},params:{id:"334430"},fullPath:"/profiles/334430",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()